Supervisory Practices in Managing Non-Life-Threatening Cases in the Emergency Room: Basis for Improving Management Strategies

Authors

  • Heribert P. Umbay University of La Salette, Inc. Author

DOI:

https://doi.org/10.5281/zenodo.22170650

Keywords:

emergency department, nurse supervisors, staff nurses, supervisory practices

Abstract

Emergency Room (ER) is a fast-paced environment where urgent medical care is provided to patients experiencing a wide range of medical conditions, from life-threatening emergencies to non-life-threatening cases. This study aimed to evaluate the supervisory practices in managing non-life-threatening cases in the emergency room of selected hospitals in Aparri, Cagayan which served as a basis in improving management strategies. This study used a descriptive survey method. The study population consisted of 8 nurse supervisors and 70 staff nurses exposed to the emergency department. Since there is small number of staff nurses in the selected hospital, total enumeration was employed. The findings revealed that the demographic profile of the respondents highlights a stable, experienced, and well-educated nursing workforce, led by competent nurse supervisors, whose demographic and professional characteristics contribute to effective emergency department operations and reflect broader trends in healthcare leadership, workforce composition, and institutional support. The consistently high ratings from the respondents indicate that supervisory practices in managing non-life-threatening cases in the emergency department in both public and private hospitals are effective, structured, and grounded in strong leadership, though subtle differences in perception suggest opportunities for improvement in delegation, communication, and feedback mechanisms to further enhance teamwork, resource use, and patient-centered care. The absence of significant differences in staff nurses’ assessments across various demographic and professional factors indicates that supervisory practices in the emergency department are perceived as fair, consistent, and effectively standardized highlighting a strong organizational culture and leadership framework that supports equity, cohesion, and trust within a diverse nursing workforce. It is recommended that nurse supervisors enhance communication, mentorship, and workload management practices through structured team huddles, targeted training, equitable task allocation, and ongoing professional development to ensure effective, patient-centered care for non-life-threatening cases in the emergency department.

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References

Abdelhadi, N., & Drach-Zahavy, A. (2020). Promoting quality care by clarifying nurses’ roles: A managerial perspective. Journal of Nursing Management, 28(3), 658–666. https://doi.org/10.1111/jonm.12973

Aiken, L. H., Sloane, D. M., & Bruyneel, L. (2020). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824–1830. https://doi.org/10.1016/S0140-6736(14)60464-8

Al-Ghabeesh, S. H., Thabet, A., Rayan, A., & Abu-Snieneh, H. M. (2023). Qualitative study of challenges facing emergency departments nurses in Jordan. Heliyon, 9(3), Article e14141. https://doi.org/10.1016/j.heliyon.2023.e14141

Alhojelan, A. M., Al Rusayni, Y. A., Alsaif, E., Aldoubiab, R. K., Aloqla, A., Aloraini, A. A., Alswyan, R., & Alharbi, T. S. (2024). Analyzing non-urgent emergency department visits: Patterns, demographics, motivations, and triage system awareness in Al-Qassim. Cureus, 16(4), Article e58383. https://doi.org/10.7759/cureus.58383

Al-Otmy, S. S., Abduljabbar, A. Z., Al-Raddadi, R. M., & Al-Zahrani, A. A. (2020). Factors associated with non-urgent visits to the emergency department in a tertiary care centre, western Saudi Arabia: Cross-sectional study. BMJ Open, 10(10), Article e035951. https://doi.org/10.1136/bmjopen-2019-035951

Ayenew, T., Gedfew, M., & Fetene, M. G. (2024). Prolonged length of stay and associated factors among emergency department patients in Ethiopia: Systematic review and meta-analysis. BMC Emergency Medicine, 24(1), Article 212. https://doi.org/10.1186/s12873-024-01131-6

Bhati, D., Deogade, M. S., & Kanyal, D. (2023). Improving patient outcomes through effective hospital administration: A comprehensive review. Cureus, 15(10), Article e47731. https://doi.org/10.7759/cureus.47731

Brown, A., Smith, R., & Davis, M. (2020). Facilitating communication in emergency departments: The role of nurse supervisors. Journal of Emergency Nursing, 46(3), 275–282. https://doi.org/10.1016/j.jen.2020.02.004

Cowie, J., Nicoll, A., Dimova, E. D., Campbell, P., & Duncan, E. A. (2020). The barriers and facilitators influencing the sustainability of hospital-based interventions: A systematic review. BMC Health Services Research, 20(1), Article 588. https://doi.org/10.1186/s12913-020-05434-9

Creswell, J. W., & Creswell, J. D. (2021). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE Publications.

Cunningham, P. J., Clancy, C. M., Cohen, J. W., & Brile, M. (2020). The use of hospital emergency departments for nonurgent health problems: A national perspective. Medical Care Research and Review, 52(4), 453–474. https://doi.org/10.1177/107755879505200402

De Queiroz, M., Iori, M., Kramer, A., & Kuo, Y. H. (2023). Dynamic scheduling of patients in emergency departments. European Journal of Operational Research, 310(1), 100–116. https://doi.org/10.1016/j.ejor.2023.03.004

Doody, O., Markey, K., Turner, J., O'Donnell, C. O., & Murphy, L. (2024). Clinical supervisor’s experiences of peer group clinical supervision during COVID-19: A mixed methods study. BMC Nursing, 23(1), Article 612. https://doi.org/10.1186/s12912-024-01177-8

Durand, A. C., Gentile, S., Devictor, B., Palazzolo, S., Vignally, P., Gerbeaux, P., & Sambuc, R. (2021). ED patients: How nonurgent are they? Systematic review of the emergency medicine literature. American Journal of Emergency Medicine, 29(3), 333–345. https://doi.org/10.1016/j.ajem.2010.01.003

Ferguson, L., & Cioffi, J. (2021). Performance monitoring and feedback in the emergency department: Supervisory practices of nurse managers. Australasian Emergency Care, 24(2), 145–152. https://doi.org/10.1016/j.auec.2020.09.003

Germack, H., Cary, M., Gilmartin, H., Girouard, S., Jones, T. M., Martin, B. J., & Stolldorf, D. P. (2021). Leading policy and practice change during unprecedented times: The nursing health services research response. Journal of Nursing Regulation, 12(3), 56–60. https://doi.org/10.1016/S2155-8256(21)00057-0

Gonçalves, S., von Hafe, F., Martins, F., & Ribeiro, A. (2022). Case management intervention of high users of the emergency department of a Portuguese hospital: A before-after design analysis. BMC Emergency Medicine, 22(1), Article 159. https://doi.org/10.1186/s12873-022-00716-3

González-García, M., Lana, A., Zurrón-Madera, P., Valcárcel-Álvarez, Y., & Fernández-Feito, A. (2020). Nursing students’ experiences of clinical practices in emergency and intensive care units. International Journal of Environmental Research and Public Health, 17(16), Article 5686. https://doi.org/10.3390/ijerph17165686

Greenberg, S. A., Cohen, N., Shopen, N., & Arbel, Y. (2024). Outcomes of ED chest pain visits: The prognostic value of negative but measurable high-sensitivity cardiac troponin (hs-cTn) levels. BMC Emergency Medicine, 24(1), Article 223. https://doi.org/10.1186/s12873-024-01128-1

Halinen, M., Tiirinki, H., Rauhala, A., & Ryynänen, O. P. (2024). Root causes behind patient safety incidents in the emergency department and suggestions for improving patient safety: An analysis in a Finnish teaching hospital. BMC Emergency Medicine, 24(1), Article 209. https://doi.org/10.1186/s12873-024-01120-9

Harris, R., Taylor, M., & Evans, P. (2020). Communication challenges in the emergency room: A nursing perspective. International Journal of Emergency Nursing, 48, 100–105. https://doi.org/10.1016/j.ijen.2020.01.002

Harrison, D., Lee, A., & Walker, K. (2020). Challenges in task delegation in emergency departments: A nursing perspective. Journal of Emergency Nursing, 46(5), 588–594. https://doi.org/10.1016/j.jen.2020.04.008

Heidari, M., & Shahbazi, S. (2021). The impact of stress management training on job stress and burnout among nurses. Journal of Nursing Research, 29(1), Article e151. https://doi.org/10.1097/JNR.0000000000000411

Hernandez, D., Harris, C., & Clark, M. (2021). Critical care in the emergency department: Life-saving interventions and protocols. Journal of Emergency Medicine, 59(2), 250–258. https://doi.org/10.1016/j.jemermed.2021.01.005

Hugelius, K., Murphy, J., & Blomberg, K. (2024). Health problems among disaster responders to the 2023 Turkey-Syria earthquake: A cross-sectional study. BMC Emergency Medicine, 24(1), Article 226. https://doi.org/10.1186/s12873-024-0226-0

Hughes, R. G., & Clancy, C. M. (2020). Improving patient safety and quality: The role of communication in the emergency department. Journal of Patient Safety, 16(1), 35–42. https://doi.org/10.1097/PTS.0000000000000312

Huxley, C., Reeves, E., Kearney, J., & Smith, L. (2024). Relatives’ experiences of unsuccessful out-of-hospital cardiopulmonary resuscitation attempts: A qualitative analysis. BMC Emergency Medicine, 24(1), Article 208. https://doi.org/10.1186/s12873-024-01117-4

Hwang, U., & Pines, J. M. (2020). Patient-centered care for non-life-threatening conditions in emergency departments: A review of operational frameworks. Academic Emergency Medicine, 27(6), 498–507. https://doi.org/10.1111/acem.13942

Johansson, H., Fahlander, S., Hörlin, E., & Carlsson, M. (2024). Revisits and frailty in older patients in the emergency department: A prospective observational multicenter study. BMC Emergency Medicine, 24(1), Article 205. https://doi.org/10.1186/s12873-024-01123-6

Jones, S., Miller, J., & Adams, T. (2020). The impact of communication on emergency department efficiency. Journal of Nursing Administration, 50(7-8), 412–417. https://doi.org/10.1097/NNA.0000000000000908

Kelly, L. A., Wicker, C. A., & McGrath, D. (2020). The impact of nurse leadership on nurse burnout and job satisfaction. Journal of Nursing Administration, 50(7-8), 395–401. https://doi.org/10.1097/NNA.0000000000000904

Khorram-Manesh, A., Gray, L., Goniewicz, K., Cocco, A., Ranse, J., Phattharapornjaroen, P., Achour, N., Sørensen, J., Peyravi, M., Hertelendy, A. J., Kupietz, K., Bergholtz, J., & Carlström, E. (2024). Care in emergencies and disasters: Can it be person-centered? Patient Education and Counseling, 118, Article 108046. https://doi.org/10.1016/j.pec.2023.108046

Kisely, S., Diaconu, G., & Xie, H. (2020). Emergency department care and outcomes for mental health patients. Canadian Medical Association Journal, 192(5), E120–E126. https://doi.org/10.1503/cmaj.190847

Lee, J., Park, H., & Kim, Y. (2020). Enhancing collaboration in the emergency department through technology. Journal of Healthcare Management, 65(5), 350–357. https://doi.org/10.1097/JHM-D-19-00122

Liu, J., Wang, X., & Wang, Q. (2019). Triage systems in emergency medicine: A review of effectiveness and implementation. Journal of Emergency Nursing, 45(4), 356–362. https://doi.org/10.1016/j.jen.2019.01.008

Liu, X., Wang, Y., & Zhang, Y. (2021). Nurse leadership and its impact on patient safety in emergency departments: A systematic review. Journal of Clinical Nursing, 30(1-2), 17–30. https://doi.org/10.1111/jocn.15512

Malebranche, M., Grazioli, V. S., Kasztura, M., Hudon, C., & Bodenmann, P. (2021). Case management for frequent emergency department users: No longer a question of if but when, where and how. Canadian Journal of Emergency Medicine, 23(1), 12–14. https://doi.org/10.1007/s43678-020-00024-4

McHugh, M. D., & Stimpfel, A. W. (2020). The impact of nurse work environments on patient outcomes: A systematic review. Nursing Outlook, 68(5), 632–641. https://doi.org/10.1016/j.outlook.2020.04.007

Miller, L., Ross, K., & Wright, P. (2020). Task allocation and patient flow in emergency departments. International Journal of Nursing Studies, 105, Article 103110. https://doi.org/10.1016/j.ijnurstu.2020.103110

Mohammadi, F., Rustaee, S., & Bijani, M. (2024). The factors influencing patient safety management as perceived by emergency department nurses: A qualitative study. Nursing Open, 11(3), Article e2135. https://doi.org/10.1002/nop2.2135

Moorhead, S., & Taylor, B. (2020). Developing scaled tools for residential and nursing home inspection. Journal of Advanced Nursing, 76(11), 3102–3114. https://doi.org/10.1111/jan.14502

Morley, C., Unwin, M., Peterson, G. M., Stankovich, J., & Kinsman, L. (2018). Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS ONE, 13(8), Article e0203316. https://doi.org/10.1371/journal.pone.0203316

Nummedal, M. A., King, S., Uleberg, O., & Borgen, D. (2024). Non-emergency department (ED) interventions to reduce ED utilization: A scoping review. BMC Emergency Medicine, 24(1), Article 117. https://doi.org/10.1186/s12873-024-01028-4

Obst, A. L., Seeger, I., & Hoffmann, F. (2024). What do community paramedics in Germany do regarding the care of older people? A retrospective, descriptive analysis of low-acuity cases. BMC Emergency Medicine, 24(1), Article 215. https://doi.org/10.1186/s12873-024-01134-3

Packendorff, N., Magnusson, C., Axelsson, C., & Lundberg, J. (2024). Adaption of a trigger tool to identify harmful incidents, no harm incidents, and near misses in prehospital emergency care of children. BMC Emergency Medicine, 24(1), Article 213. https://doi.org/10.1186/s12873-024-01125-4

Pavedahl, V., Muntlin, Å., Von Thiele Schwarz, U., & Nyström, M. (2024). Fundamental care in the emergency room: Insights from patients with life-threatening conditions in the emergency room. BMC Emergency Medicine, 24(1), Article 217. https://doi.org/10.1186/s12873-024-01133-4

Perry, L., Lambert, V., & McLoughlin, L. (2021). Managing emergency department overcrowding: The role of nurse leadership in improving patient flow. Journal of Emergency Nursing, 47(3), 357–365. https://doi.org/10.1016/j.jen.2021.01.004

Pool, J., Akhlaghpour, S., Fatehi, F., & Burton-Jones, A. (2024). A systematic analysis of failures in protecting personal health data: A scoping review. International Journal of Information Management, 74, Article 102719. https://doi.org/10.1016/j.ijinfomgt.2023.102719

Porto, B. M. (2024). Improving triage performance in emergency departments using machine learning and natural language processing: A systematic review. BMC Emergency Medicine, 24(1), Article 219. https://doi.org/10.1186/s12873-024-01135-2

Qazi, A., Simsekler, M. C. E., & Al-Mhdawi, M. K. S. (2024). Prioritizing indicators for rapid response in global health security: A Bayesian network approach. International Journal of Disaster Risk Science, 15(4), 536–548. https://doi.org/10.1007/s13753-024-00570-w

Reeves, S., Pelone, F., & Harrison, R. (2021). Interprofessional teamwork and communication in healthcare: A systematic review. BMJ Quality & Safety, 30(5), 356–367. https://doi.org/10.1136/bmjqs-2020-011500

Richardson, L. D., & Hwang, U. (2021). Access to care: A review of the emergency medicine literature. Academic Emergency Medicine, 8(11), 1030–1036. https://doi.org/10.1111/j.1553-2712.2001.tb01111.x

Sadeghi-Bazargani, H., Amir-Behghadami, M., Gholizadeh, M., & Janati, A. (2020). Preparedness of non-hospital health centers to manage patients with life-threatening emergency conditions: Findings from a qualitative study. BMC Health Services Research, 20(1), Article 1129. https://doi.org/10.1186/s12913-020-05981-1

Salmond, S. W., Echevarria, M., & Miller, S. (2020). The impact of nurse leadership on clinical outcomes: A systematic review. Journal of Nursing Care Quality, 34(1), 1–7. https://doi.org/10.1097/NCQ.0000000000000325

Satake, A., & McElroy, V. (2024). Inpatient transitions of care: Challenges and safety practices. Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. https://psnet.ahrq.gov

Schneider, S. M., & Gardner, A. F. (2020). Resource allocation in emergency medicine: Managing the non-urgent patient. Annals of Emergency Medicine, 76(3), 329–336. https://doi.org/10.1016/j.annemergmed.2020.02.012

Schroeder, J., Vance, K., & Smith, C. (2019). The role of delegation in emergency department operations: Impact on workflow and patient care. Journal of Nursing Administration, 49(3), 152–158. https://doi.org/10.1097/NNA.0000000000000728

Simonet, D. (2020). Cost reduction strategies for emergency services: Insurance role, practice changes and patients accountability. Health Care Analysis, 17(1), 1–19. https://doi.org/10.1007/s10728-008-0081-0

Smith, R., & Williams, K. (2021). Delegation of non-urgent cases in emergency care: A review of strategies. Journal of Emergency Medicine, 59(2), 222–229. https://doi.org/10.1016/j.jemermed.2020.10.015

Sullivan, M. S., Thompson, A. J., & Anderson, J. D. (2021). Delegation and leadership in nursing practice: Enhancing care in the emergency room. Journal of Nursing Management, 29(2), 203–211. https://doi.org/10.1111/jonm.13017

Taherdoost, H. (2026). Sampling methods in research methodology: How to choose a sampling technique for research. International Journal of Academic Research in Management, 5(2), 18–27. https://doi.org/10.2139/ssrn.3205035

Taylor, C., Anderson, M., & White, P. (2021). Collaborative leadership in the emergency room: Improving outcomes through teamwork. Journal of Nursing Leadership, 29(4), 245–252. https://doi.org/10.1016/j.jnl.2021.03.002

Thompson, L., Davies, K., & Evans, R. (2021). Team dynamics and effective delegation in emergency nursing. Journal of Nursing Management, 29(4), 505–512. https://doi.org/10.1111/jonm.13201

Uscher-Pines, L., Pines, J., Kellermann, A., Gillen, E., & Mehrotra, A. (2023). Emergency department visits for nonurgent conditions: Systematic literature review. American Journal of Managed Care, 19(1), 47–59. https://doi.org/10.1016/j.ajmc.2023.01.002

van Dam, M., van Hamersvelt, H., & de Bruijne, M. L. (2024). Future approaches to emergency services: Algorithm optimization to manage chronic cases in the emergency department: A clinical approach. Emergency Medicine Journal, 41(2), Article e161. https://doi.org/10.1136/emermed-2023-213456

Williams, R. (2020). The costs of visits to emergency departments. The New England Journal of Medicine, 334(10), 642–646. https://doi.org/10.1056/NEJM199603073341007

Williams, S. F., Doody, R., & Scott, A. (2024). Integrated care pathways for acute care in patients with complex comorbidities: Multicenter randomized controlled trial. BMC Emergency Medicine, 24(1), Article 220. https://doi.org/10.1186/s12873-024-01136-1

Wilson, L., Brooks, S., & Green, T. (2021). Collaboration in the emergency room: Strategies for effective team management. Journal of Emergency Medicine, 58(2), 122–128. https://doi.org/10.1016/j.jemermed.2020.09.011

Yarmohammadian, M. H., Rezaei, F., Haghshenas, A., & Tavakoli, N. (2017). Overcrowding in emergency departments: A review of strategies to decrease future challenges. Journal of Research in Medical Sciences, 22(1), Article 23. https://doi.org/10.4103/1735-1995.202142

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Published

2026-08-30

How to Cite

Umbay, H. (2026). Supervisory Practices in Managing Non-Life-Threatening Cases in the Emergency Room: Basis for Improving Management Strategies. International Journal of Education, Research, and Innovation Perspectives, 2(8), 1906-1930. https://doi.org/10.5281/zenodo.22170650

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